Emma Rary

The health of individuals and communities is more interconnected than ever, and emergent technologies have the potential to improve public health monitoring at both the community and individual level. A systematic literature review of peer-reviewed and gray literature from 2000-present was conducted on the use of biosensors in sanitation infrastructure (such as toilets, sewage pipes and septic tanks) to assess individual and population health. 21 relevant papers were identified using PubMed, Embase, Global Health, CDC Stacks and NexisUni databases and a reflexive thematic analysis was conducted. Biosensors are being developed for a range of uses including monitoring illicit drug usage in communities, screening for viruses and diagnosing conditions such as diabetes. Most studies were nonrandomized, small-scale pilot or lab studies. Of the sanitation-related biosensors found in the literature, 11 gathered population-level data, seven provided real-time continuous data and 14 were noted to be more cost-effective than traditional surveillance methods. The most commonly discussed strength of these technologies was their ability to conduct rapid, on-site analysis. The findings demonstrate the potential of this emerging technology and the concept of Smart Sanitation to enhance health monitoring at the individual level (for diagnostics) as well as at the community level (for disease surveillance).